Monday, May 12, 2008


Tom Reynolds and his like (ambulance “drivers” and paramedics) are always justifiably moaning about call-outs to non-emergency cases.

The Public is not calling our 24 hour NHS Direct service as they will not get to talk to a doctor. They will not call their GP as they will receive a pre-recorded reply to call NHS Direct or, if an emergency, an ambulance to A & E.

So they dial 999 and an ambulance is dispatched to dispatch a paracetamol.

The GPs are fed up. The Ambulance Crews are fed up. The A & E doctors and nurses are fed up. Many feel (GPs, A & E doctors and nurses, ambulance crews, punters etc) that the GPs provided better Out of Hours (OOH) service before the new GP contract in 2004 which saw the PCTs assume direct responsibility for OOH service. The PCTs were not provided with extra money for OOH (or if they were, spent it on something else), did not contract the GPs to provide it and thought they could scrimp and save (can someone inform me?) by getting their A & E to take up the slack.

So Dear Tom you get called out to serve up a Paracetamol ...

And, on top of this, we have the NHS Healthcare Travel Costs Scheme (HTCS - a reimbursement scheme, most recent guidelines here) ... except it does not cover irregular visits to a GP nor A & E ... I won't be reimbursed for a 02:30 trip to A & E. So Tom, you are called at 2:30 am to administer a Paracetamol when previously my GP would rouse himself from his slumbers, reassure me over the phone that it could wait until morning, to take a paracetamol and both of us would go back to sleep ... or I would rush down to A & E in an ambulance as it was a real emergency.

“With the introduction of Free Choice, patients may be referred to a wider variety of healthcare providers. However, they will expect HTCS be operated consistently between providers and across different areas."

Now that we have NHS Free Choice Ican take a taxi from John O'Groats to Land End at NHS expense.

Take it Tom – much of your job is now a glorified taxi service.

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